The way forward: How can Texas fix this?

A new Houston Chronicle investigation, In Crisis, reveals that the state’s mental health system is overcrowded, underfunded and lacks critical safeguards.

Despite increases in funding for mental health services in recent years, the state has struggled to keep up with population growth and overcome funding cuts in the early 2000s.

Here are some proposals by experts, advocates and lawmakers that would improve the state’s broken mental health system:

• Provide additional funding for programs that help a person regain competency to stand trial both in jail and out in the community, which could reduce the need for inpatient beds at state hospitals. Competency restoration is important to ensure that defendants understand the charges against them and that they can participate in their defense.

• Fully fund the state’s 2017 plan to add 656 beds to the state psychiatric hospital system.

• Create a centralized tracking system that would allow for analysis of decisions made by the Dangerousness Review Board, the state board that decides the security level required for patients accused of crimes. This is needed to ensure the board is making the correct decision in moving a person to minimum security from maximum security and that patients in the minimum security setting are being kept safe.

• Make the board’s hearings and documents open to the public, similar to the disclosure by other states, including Arizona and Oregon.

• Require that the state investigate all deaths at state-run and funded mental hospitals. Make the investigations into those cases public with the necessary redactions for patient privacy.

• Require state officials to report all deaths to the federal government for investigation, not just those related to restraint and seclusion.

• Make it easier for family members to take legal action against state hospitals if a relative is injured or dies. Currently, loved ones can sue only if they can prove that the state violated a patient’s constitutional rights, such as due process. A family cannot simply sue for neglect.

• Provide funding for mental health emergency teams across the state, which can respond to mental health calls alongside police, similar to Dallas’ RIGHT Care program. Through this program, a three-member team of a specially trained police officer, paramedic and mental health specialist are dispatched to calls suspected to be mental health-related. The program, which launched in 2018, was funded with a $7 million grant spread over three years; it would be significantly more expensive to expand it to more areas.